Primary sclerosing cholangitis (PSC) is a chronic progressive liver disease that is characterized by on-going inflammation and destruction of intrahepatic and extrahepatic bile ducts. Primary sclerosing cholangitis generally affects middle aged men and id the fourth leading indication for liver transplantation in adults in the United States. In this pilot trial, the efficacy of four different treatment regimen will be prospectively studied: a. ursodiol alone; b. ursodol and rotating oral antibiotics; c. ursodiol and low-dose oral methotrexate and rotating oral antibiotic in patients with PSC. The course and the treatment of PSC will be studied over a duration of 4 years.